Good morning. Alberta, Ontario and Quebec all have unique takes on fixing the health-care crunch – more on that below, along with a potential Air Transat pilot strike and Spotify Wrapped’s most-streamed artist. (Sorry, Swifties.) But first:

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It’s no secret that Canadian health care is in rough shape. We may shell out $399-billion each year on hospitals, drugs and physician services, but our return on investment is far from ideal. At least 6.5 million Canadians don’t have a family doctor. Wait times for surgeries now average 30 weeks. Emergency rooms are either overcrowded or straight-up closed, and new drugs can take years before they’re available here.

Patients need better care, and some provinces have very different ideas about how to go about it. Let’s take a look at three recent approaches to clear doctors’ queues.

Ontario’s model: Give doctors a carrot

What that means: Money, mostly. In September, Premier Doug Ford’s government inked a deal with Ontario physicians to deliver a 7.3-per-cent pay bump over the next three years, plus new compensation for all the admin work that family doctors take on. Ford also promised $2.1-billion earlier this year to tackle the shortage in primary care, and he’s had some success getting people off the wait list for a family doctor. As of Jan. 1, there were approximately 235,000 people on Ontario’s Health Care Connect list; the government says 65 per cent of them now have a medical provider.

What could go wrong: That Health Care Connect list is just the tip of the iceberg. Last year, the Ontario College of Family Physicians estimated 2.5 million Ontarians had no family doctor – and there will soon be far fewer of them to go around. A new survey from the Ontario Medical Association found that 52 per cent of primary physicians are eyeing retirement in the next five years. At the same time, only 42 per cent of Ontario medical students say they’re even considering family medicine as a career. Ford might want to reverse his new rule limiting international medical students from applying for residency spots.

Quebec’s model: Show doctors a stick

What that means: Dramatically changing the way they’re paid. Quebec’s Bill 2, meant to take effect in January, dispenses with the current fee-for-services system and instead ties compensation to the number of patients a doctor enrolls. And if the province’s physicians, as a collective, fail to hit certain targets – ensuring every Quebecker has a family doctor by next summer, for example, or that 75 per cent of ER patients are seen within 90 minutes – the government will claw back as much as 15 per cent of their pay. Oh, and if doctors protest the new law with work slowdowns or stoppages? They’ll face a fine of up to $20,000 a day.

What could go wrong: You could have a bunch of Quebec doctors threatening to resign, find other work or leave the province altogether – which is exactly what’s happened. They argue Bill 2 amounts to a drastic pay cut that will also hamper their ability to provide adequate care. Quebec pediatricians, for example, point to a potentially disastrous loophole: Healthy children, even newborns, have been classified as among the least vulnerable patients, bumping them down the priority list and compensating doctors relatively little for taking them on.

Alberta’s model: Let doctors double dip

What that means: They can toggle between the public and private health care systems. Late last month, Alberta introduced a bill that allows physicians to offer their services in both markets, a hybrid model that the government argues has shortened wait times in Denmark and France. Premier Danielle Smith said that surgeons would be the focus of the new approach, though her Minister of Hospital and Surgical Health Services, Matt Jones, told reporters the scope could be “broader than surgical activity” and include family doctors.

What could go wrong: It’s hard to know yet, because no other province has actually tried this before – doctors have to choose whether they want to bill the public purse or privately charge patients for care. Physicians who study Alberta’s work force believe that the model could prove lucrative for some providers, but it’s unlikely to create much new capacity in the system. And critics like Alberta NDP Leader Naheed Nenshi warn the changes amount to “American-style medicine,” where wait times will get longer for those who can’t afford to pay. Although, as Robyn Urback points out, Canada’s single-tier health care is already a mirage: If you have time and resources, you can usually buy your way out of the queue.

Canadian snowbirds are scouting further afield for their vacation homes – maybe Portugal, maybe Costa Rica, maybe Mexico.